Through case analysis of Novartis’ issues management and public relations strategy in South Korea, the study explores how Korean health activists evaluate the relationship with Novartis and the factors behind the negative evaluations of public relations and CSR (Corporate Social Responsibility) strategies. The study found that although they are satisfied with the relationship with Novartis and they benefit from the outcomes of Novartis’ CSR activities, the health activists don’t regard the company as good or trustworthy. Their reasons lie in two beliefs. First, they think the company never put patients’ and the community’s wellbeing before its financial interests. Also, they claimed that Novartis’ effort in CSR investment is insufficient repayment to the community in comparison to its great success in the Korean market. The study suggests global pharmaceutical company’s issues management should consider local culture and politics to build a better deal with issues raised by local health activism.